Individual provider Active NPI

Mark Vincent Johnson, M.D.

  • Diagnostic Radiology Physician
  • Mobile, AL
National Provider Identifier
1740222587
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
21483 Issued in AL
Practice address
3719 Dauphin St
Mobile, AL 36608-1753
Phone
(251) 340-7786
Fax
(251) 461-2030
NPI assigned
Jun 12, 2006
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 21483 AL Primary

Addresses

Primary practice location

3719 Dauphin St
Mobile, AL 36608-1753

Mailing address

3719 Dauphin St
Mobile, AL 36608-1753
Phone (251) 340-7786

Other practice location 1

140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690
Phone (662) 628-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041209000656 MS Practitioner - Diagnostic Radiology 6709847056 Reassigns benefits to 9 organizations
I20060124000268 AL Practitioner - Diagnostic Radiology 6709847056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Pre Op and Imaging Center LLCGroup PAC ID 0840444998, 20 clinicians
Imaging Centers for Excellence, LLCGroup PAC ID 6406854538, 17 clinicians
Springhill Diagnostic Radiologists, P.C.Group PAC ID 0042298978, 5 clinicians
Boa Vida Hospital of Aberdeen Ms LLCGroup PAC ID 0244505840, shared by 26 NPIs, 70 clinicians
Tate County HospitalGroup PAC ID 6103282165, 35 clinicians
Premier Radiology IncGroup PAC ID 2769452242, 26 clinicians

Practice addresses (Care Compare)

1202 Office Park Dr
Suite a
Oxford, MS 38655-5267
Phone (662) 234-5545

1207 Hwy 182 W
Suite a
Starkville, MS 39759-9013
Phone (662) 320-6800

17550 E Main St
Louisville, MS 39339-2772
Phone (662) 773-6211

3719 Dauphin St
Mobile, AL 36608-1753
Phone (251) 460-0326

400 S Chestnut St
Aberdeen, MS 39730-3335
Phone (662) 369-2455

401 Getwell Dr
Senatobia, MS 38668-2213
Phone (662) 612-0311

8 Hathaway Rd S
Mobile, AL 36608-1948
Phone (662) 842-1758

830 S Gloster St
Radiology Consultants
Tupelo, MS 38801-4934
Phone (662) 377-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.72 of 100Reported as group
Quality
80
Improvement activities
40
Cost
75.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21483ALMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Radiology, Inc Diagnostic Radiology CurrentSince Oct 29, 2023 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Jul 1, 2024 Accepting new patients
Baptist Memorial Hospital-Calhoun Inc CurrentSince Nov 15, 2023 Accepting new patients
Choctaw Regional Medical Center Current Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Dec 20, 2025 Accepting new patients
Tate County Hospital Current Accepting new patients
Winston County Medical Foundation CurrentSince Feb 5, 2024 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Jul 1, 2024 Accepting new patients
Choctaw Regional Medical Center CurrentSince Jan 23, 2024 Accepting new patients
Tate County Hospital CurrentSince May 19, 2024 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC Current Accepting new patients
Imaging Centers for Excellence, LLC Diagnostic Radiology CurrentSince Feb 1, 2024 Accepting new patients
Wave Diagnostics LLC CurrentSince Jul 1, 2025 Accepting new patients
Springhill Diagnostic Radiologists, P.C. CurrentSince Apr 1, 2007 Accepting new patients
Oxford Pre Op & Imaging Center LLC CurrentSince Jan 21, 2024 Accepting new patients
Baptist Memorial Hospital-Calhoun Inc Current Accepting new patients
North Mississippi Medcial Center, Inc. Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Baptist Memorial Hospital - Calhoun, Inc Past Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC Past Accepting new patients
Amory Primary Medicine Clinic Past Accepting new patients
Medplus Urgent Clinic LLC Past Accepting new patients

Locations

1256 Military St S
Hamilton, AL 35570
Phone (205) 921-6200

3719 Dauphin St
Mobile, AL 36608
Phone (251) 342-3000

202 Hospital St
Moulton, AL 35650
Phone (256) 974-2200

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

8613 MS Highway 12
Ackerman, MS 39735
Phone (662) 285-4400

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

1107 Earl Frye Blvd
Ste 6
Amory, MS 38821
Phone (601) 256-9327

112 Medical Arts Dr
Calhoun City, MS 38916
Phone (662) 628-1274

17550 E Main St
Louisville, MS 39339
Phone (662) 446-1072

1202 Office Park Dr
Ste A
Oxford, MS 38655
Phone (662) 234-5545

3509 Highway 4 W
Sarah, MS 38665
Phone (662) 612-0311

401 Getwell Dr
Senatobia, MS 38668
Phone (662) 562-3100

140 Burke Calhoun City Rd
Slate Spring, MS 38916
Phone (662) 628-6611

1207 Highway 182 W
Ste A
Starkville, MS 39759
Phone (662) 320-6800

620 Crossover Rd
Tupelo, MS 38801
Phone (662) 620-7101

620 Crossover Rd
#A
Tupelo, MS 38801

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

891 Mississippi Dr
Tupelo, MS 38804
Phone (662) 377-6800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBJABD
  • Direct secure messaging: mark.johnson.1@15070.direct.athenahealth.com
  • Direct secure messaging: markjohnson@nmhs.medalliesdirect.net

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1740222587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081753",
            "telephone_number": "251-340-7786",
            "fax_number": "251-461-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081753",
            "telephone_number": "251-340-7786",
            "fax_number": "251-461-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Burke Calhoun City Rd",
            "address_purpose": "LOCATION",
            "city": "Calhoun City",
            "state": "MS",
            "postal_code": "389169690",
            "country_code": "US",
            "telephone_number": "662-628-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARK",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "21483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.